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    Managing Side Effects

    Every person's reaction to cancer treatment is unique. No one can predict which side effects you will experience or how severe they might be.

    Below are some of the most common side effects experienced and recommendations for managing them. It is important to speak with your doctor about the side effects you are experiencing to get suggestions more specific to your situation.

    Fatigue

    Everyone has different energy levels, so cancer treatment affects each patient differently. Many patients require a whole year to recover. Even after that, life might not return to the "normal" you had before cancer. You might find you need to permanently change your lifestyle to prevent fatigue and cope with the long-term effects of treatment.

    Although fatigue is a typical and often expected side effect of cancer and its treatments, mention your concerns to your doctor. There are times when fatigue might indicate an underlying medical problem.

    Tips to manage

    • Keep a diary for a week to identify the time of day you are the most tired and the time of day you have the most energy. Note what you think the causes might be.
    • Plan, organize, and prioritize your daily activities. Decide which activities you need to do and which activities you can put off or ask someone else to do.
    • Balance periods of rest and work. Rest before you become tired. Frequent, short rests are beneficial.
    • Pace yourself. A slow pace is better than rushing through activities.
    • Exercise daily. Walking is an excellent way for you to regain your strength and stamina.
    • Eat a well-balanced, nutritious diet.

    Concentration and memory issues (chemo brain)

    The drugs used to treat cancer can cause some people to have trouble concentrating or remembering things. This is often called “chemo brain.” Most define it as a decrease in mental sharpness and describe it as being unable to remember certain things, concentrate on something, or learn new skills.

    Tips to manage

    • Write everything down! Use a daily planner, notebook, or smartphone to keep track of appointments, to-do lists, important dates, websites, phone numbers, meeting notes, and anything else you want to remember.
    • Exercise your brain. Take a class, play word games, or learn a new language.
    • Get plenty of sleep.
    • Exercise regularly to improve your mood and decrease tiredness.
    • Focus on one thing at a time – avoid multitasking.
    • Ask for help. Friends and family can help with daily tasks to cut down on distractions and help you save mental energy.
    • Keep a diary of when you notice problems and what's going on at the time, including medications you took, time of day, and what you were doing. This can help you identify what may be causing your memory issues. Knowing when the problems are most noticeable will also help you avoid planning important conversations or meetings during those times.
    • Although difficult, try not to focus on how much these symptoms bother you. And keep in mind, you probably notice it much more than others do.

    Nausea and vomiting

    Nausea may or may not be accompanied by vomiting. It can last from a few hours to several weeks after treatment.

    There are many types of anti-nausea medicines your doctor can prescribe. If a particular medicine is not helping your nausea, tell your doctor so they can prescribe a different one.

    Tips to manage

    • Nausea is usually worse when your stomach is empty, so eat small meals frequently throughout the day.
    • Eat cold or lukewarm foods. The smell of hot foods may make you more nauseous.
    • Do not mix hot and cold foods or eat too fast. Doing so might bring on vomiting.
    • Avoid foods that are hard to digest, like fried foods or high-fat foods.
    • Rest after eating. If you need to lie down, lay on your right side and keep your head elevated.
    • Drink enough fluids to prevent dehydration.

    Loss of appetite

    Feeling nauseous might cause you to lose your appetite. It is vital to make an effort to eat even if you don't feel like it. Eating balanced, nutritious meals provides your body with the energy it needs to recover from treatment and fight infections.

    Tips to manage

    • Eat small meals or snacks six to eight times a day.
    • Drink beverages after meals instead of before or during to avoid feeling too full.
    • Eat more protein and fat and fewer simple sugars. Eggs, fish, peanut butter, ice cream, yogurt, peas, beans, and nuts can provide you with high nutritional content and high protein in small portions.
    • Don't waste your energy eating foods that provide little or no nutritional value, like potato chips, candy, or other highly-processed foods.

    Hair loss

    Radiation and chemotherapy cause hair loss, which can be temporary or permanent.

    If your hair loss is temporary, it might start to regrow within three to six months. When your hair begins to regrow, you may notice that the texture or color is different than before.

    Tips to manage

    • Use a mild shampoo like baby shampoo that doesn't have perfumes or harsh chemicals.
    • Avoid applying hair spray, oils, creams, and heat sources to your hair.
    • Wash your scalp with warm water and pat dry with a soft towel. Avoid rubbing.
    • Protect your head from the sun, cold, and wind.
    • For more tips on coping with hair loss, visit the American Cancer Society's webpage on Coping with Hair Loss.

    Neuropathy

    Peripheral neuropathy can occur after chemotherapy. It results from damage to the nerves outside of the brain and spinal cord (peripheral nerves). Symptoms include weakness, numbness, and pain, usually in the hands and feet.

    Although chemo-induced neuropathy can't be prevented, there are things you can do to manage the symptoms.

    Tips to manage

    • Avoid things that make your neuropathy worse, like hot or cold temperatures or tight clothes or shoes.
    • Give yourself extra time to do things and ask for help when you need it.
    • Avoid alcohol, as it can make your neuropathy worse.
    • If you have diabetes, control your blood sugar. High blood sugar levels can damage nerves.
    • If the neuropathy is in your feet, sit down whenever possible.
    • If your neuropathy is permanent, your doctor may refer you to an occupational therapist to help you balance your daily life with your physical limitations.

    Infertility

    Some treatments may cause infertility. Hormonal changes, excessive fatigue, pain, or changes in your self-image may also impact your sexual desire.

    Before you start cancer treatment, discuss your concerns about fertility with your doctor. If you have a partner, you may want to include them in these conversations so you both have an understanding of how treatment may impact your ability to have children in the future.

    Tips to manage

    • Concerns about fertility can be distressing, so it might help to seek counseling with your social worker, a professional therapist, or a fertility preservation specialist.
    • Some ways to increase your chances of having children after cancer treatment include sperm banking, in vitro fertilization, and intra-cytoplasmic sperm injection (a procedure in which sperm is injected directly into an egg).
    • For more information on managing sexual side effects, download the American Cancer Society's booklet on sexuality and cancer.

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